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Get Collateral Securities Pledge Form--state - OK.gov

OR TREASURER'S USE ONLY $ Name of Pledgor Bank / Issue Date City Original Face Amount Mailing Address Date Date Submit Original Form with each Custody Receipt to: Name and title of Duly Authorized Bank Officer (Please type or print clearly) SUBSTITUTION City Security Registrar, State Treasurer's Office Signature of Duly Authorized Bank Officer of the Pledgor Bank Name of Safekeeping Bank Issuing Custody Receipt Scott Meacham, State Treasurer 217 State Capitol 2300 N. Lincoln Blv.

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